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Biopsy Of The Roof Of The Mouth

Oregon rates for HCPCS 42100

Takes a small piece of tissue from the roof of the mouth or from the uvula, the flap hanging at the back of the throat, so it can be examined under a microscope. Only a sample is taken and the rest of the area is left in place. It is done to find out what is behind a patch, sore, swelling or growth that has not settled on its own.

Rates data updated July 2026.

Facilitymedian $234 · 10th–90th $129$3630%20%10th90th$234Professionalmedian $219 · 10th–90th $115$3890%10%20%10th90th$219$2.0$20.0$200.0$2.0K$20.0K$200.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$380.19
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$158.49
Typical High
$616.60
Cigna
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$1,949.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$245.47
Typical High
$389.05
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$257.04
Typical High
$363.08
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$177.83
Typical High
$316.23
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$251.19
Typical High
$354.81
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$281.84
Typical High
$295.12
Providence
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$177.83
Typical High
$316.23
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$275.42
Typical High
$371.54
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$5,011.87
Typical High
$6,025.60
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$288.40
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$4,677.35
Typical High
$7,244.36
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$245.47
Typical High
$380.19